Observation direct referral from physician office for admission at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$678.62
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$1,575.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$258.30 with AETNA vs $13,850.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $258.30 | ↓ -62% |
| CLOVER | MEDICARE ADVANTAGE | $283.50 | ↓ -58% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $294.53 | ↓ -57% |
| VACCN | ALL PRODUCTS | $678.62 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $678.62 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $678.62 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $678.62 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $712.55 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $739.69 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $814.34 | ↑ +20% |
| HORIZON | PIP | $1,015.88 | ↑ +50% |
| BERGEN RISK | ALL PRODUCTS | $1,181.25 | ↑ +74% |
| AETNA | ASA | $1,233.23 | ↑ +82% |
| CIGNA | BH | $1,260.00 | ↑ +86% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,278.00 | ↑ +88% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,338.75 | ↑ +97% |
| QUALCARE | WORKERS COMP | $1,386.00 | ↑ +104% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $1,417.50 | ↑ +109% |
| HORIZON | MANAGED MEDICAID | $1,907.00 | ↑ +181% |
| QUALCARE | PPO | $3,820.00 | ↑ +463% |
| QUALCARE | HMO | $3,953.00 | ↑ +483% |
| HORIZON | OMNIA | $5,853.00 | ↑ +762% |
| HORIZON | SHP | $6,707.00 | ↑ +888% |
| AMERIHEALTH | LOCAL HMO | $6,929.00 | ↑ +921% |
| HORIZON | HMO | $7,231.00 | ↑ +966% |
| HORIZON | INDEMNITY | $7,331.00 | ↑ +980% |
| HORIZON | PPO | $7,402.00 | ↑ +991% |
| AMERIHEALTH | REGIONAL HMO | $7,833.00 | ↑ +1054% |
| CIGNA | HMO | $10,036.00 | ↑ +1379% |
| CIGNA | PPO | $10,036.00 | ↑ +1379% |
| HORIZON | WORKERS COMP | $10,149.00 | ↑ +1396% |
| OXFORD | ALL PRODUCTS | $11,969.00 | ↑ +1664% |
| AETNA | PPO | $13,324.00 | ↑ +1863% |
| AETNA | HMO | $13,324.00 | ↑ +1863% |
| UNITED HEALTHCARE | HMO | $13,850.00 | ↑ +1941% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $328.47 | $670.04 – $8,116.00 |
| Cooperman Barnabas Medical Center | Livingston | $370.82 | $687.85 – $8,203.00 |
| Community Medical Center | Toms River | $362.95 | $670.04 – $7,757.00 |
| Clara Maass Medical Center | Belleville | $348.07 | $687.85 – $4,982.00 |
| Newark Beth Israel Medical Center | Newark | $364.52 | $687.85 – $6,387.00 |
| Jersey City Medical Center | Jersey City | $363.65 | $722.02 – $5,761.00 |
| Monmouth Medical Center | Long Branch | $382.90 | $678.62 – $7,121.00 |
| Hackensack University Medical Center | Hackensack | $722.02 | $577.62 – $10,511.00 |